FUNCTIONAL PHYSICAL THERAPY CENTER (NPI# 1902182298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902182298 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL PHYSICAL THERAPY CENTER |
| Practice Address |
8950 W Emerald St Suite 195 Boise ID 83704-4854 |
| Practice Telephone | 2083767313 |
| Practice Fax Number | 2083767487 |
| Mailing Telephone | 2083767313 |
| Mailing Fax Number | 2083767487 |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2012-04-16 |
| Authorized Official Name | RAJCOOMAR ISSUREE (PHYSICAL THERAPIST/DIRECTOR) |
| Authorized Official Telephone | 2083767313 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT670 | ID | Ambulatory Health Care Facilities |
| Street Address |
8950 W EMERALD ST SUITE 195 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-4854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801867817 | Helen A Napier | Psychologist | 8950 W Emerald St, Suite 168, Boise, ID 83704-4854 | 2006-01-28 |
| 1316579543 | Jennelle Johnson | Social Worker | 8950 W Emerald St, Boise, ID 83704-4854 | 2020-02-05 |
| 1619515095 | Sarah Gordon | Social Worker | 8950 W Emerald St, Boise, ID 83704-4854 | 2019-12-16 |
| 1598278673 | Kersondra Corrine Hood | Social Worker | 8950 W Emerald St, Boise, ID 83704-4854 | 2017-11-10 |
| 1831643154 | Lindsay Rae Kenley | Counselor | 8950 W Emerald St, Suite 178, Boise, ID 83704-4854 | 2016-08-04 |
| 1669844320 | Jacqueline Smithee | Counselor | 8950 W Emerald St, Suite 178, Boise, ID 83704-4854 | 2015-10-21 |
| 1629440383 | Sarah Lyter | Counselor | 8950 W Emerald St, Suite 178, Boise, ID 83704-4854 | 2015-10-21 |
| 1497143507 | Precision Performance and Therapy | Physical Therapist | 8950 W Emerald St, Ste 150, Boise, ID 83704-4854 | 2014-12-26 |
| 1023412202 | Christa M Stallworth | Counselor | 8950 W Emerald St, Suite 178, Boise, ID 83704-4854 | 2014-10-16 |
| 1134548373 | Norma Alicia Guillen | Social Worker | 8950 W Emerald St, Suite 178, Boise, ID 83704-4854 | 2014-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356964449 | Vibrant Physical Therapy & Wellness | Clinic/Center | 1111 S Orchard St Ste 104, Boise, ID 83705-1961 | 2020-05-22 |
| 1477193795 | Zona Physical Therapy | Clinic/Center | 11483 W Fairview Ave, Boise, ID 83713-7940 | 2020-01-15 |
| 1427565845 | Premier Physical Therapy Inc | Clinic/Center | 13967 W Wainwright Dr Ste 104, Boise, ID 83713-2094 | 2018-01-08 |
| 1790294973 | The Pt Next Door | Clinic/Center | 6098 E. Grand Prairie Drive, Boise, ID 83716 | 2017-09-20 |
| 1023381472 | Small Steps Pediatric Therapy, Pllc | Clinic/Center | 6180 W Emerald St, Boise, ID 83704 | 2012-02-15 |
| 1013206002 | Sawtooth Physical Therapy | Clinic/Center | 7979 W Rifleman St Ste 200, Boise, ID 83704-9066 | 2011-03-31 |
| 1144334525 | Intermountain Physical Therapy Limited Partnership | Clinic/Center | 554 Steelhead Way, Suite 162, Boise, ID 83704-8391 | 2006-08-19 |
| 1043855505 | Destinations Physical Therapy | Clinic/Center | 12951 W Goldenrod Ave, Boise, ID 83713-2510 | 2019-11-08 |
| 1881180776 | Proximity Telehealth LLC | Clinic/Center | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2018-07-03 |
| 1487142279 | Proximity Physical Therapy LLC | Clinic/Center | 6098 E Grand Prairie Dr, Boise, ID 83716-4700 | 2018-04-26 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.